University of Exeter Medical School, Exeter, UK.
Sociol Health Illn. 2020 Jun;42(5):1123-1138. doi: 10.1111/1467-9566.13084. Epub 2020 Apr 6.
Narratives of self-responsibility are pervasive in neoliberally oriented contexts, and have been found to engender feelings of shame and failure amongst those affected by poverty. Here, we use findings from research in two low-income communities in south-west England to examine how these narratives become embodied within people's daily lives when they intersect with systems of welfare support and the current political drive to upscale treatment for common mental health conditions. Drawing on Bourdieu's notion of symbolic violence, we examine how narratives of self-responsibility and associated welfare reform strategies impact on the mental health of people living in economic hardship. The data show how such narratives inflict, sustain and exacerbate mental distress and suffering, and how they become naturalised and normalised by individuals themselves. We demonstrate how this situation pushes people to seek support from General Practitioners, and how clinical interactions can normalise, and in turn, medicalise, poverty-related distress. Whilst some people actively resist dominant narratives around self-responsibility, we argue that this is insufficient under broader sociocultural and political circumstances, to free themselves from the harms perpetuated by symbolic violence.
在新自由主义导向的背景下,自我负责的叙述普遍存在,并已被发现会在受贫困影响的人群中引起羞耻和失败感。在这里,我们利用英格兰西南部两个低收入社区的研究结果,研究了当这些叙述与福利支持系统以及当前提高常见心理健康状况治疗水平的政治动力相交织时,它们如何在人们的日常生活中体现出来。借鉴布迪厄的象征性暴力概念,我们研究了自我负责的叙述和相关的福利改革策略如何影响生活在经济困难中的人们的心理健康。数据显示,这种叙述是如何造成、维持和加剧精神痛苦和苦难的,以及它们是如何被个人自身自然化和正常化的。我们展示了这种情况如何促使人们向全科医生寻求支持,以及临床互动如何将与贫困相关的痛苦正常化,并进而将其医学化。虽然有些人积极抵制自我负责的主导叙述,但我们认为,在更广泛的社会文化和政治环境下,这种抵制是不够的,无法使他们免受象征性暴力造成的伤害。